Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Purpose To evaluate the feasibility of cardiac magnetic resonance fractal analysis in evaluating left ventricular trabecular complexity in hypertrophic cardiomyopathy(HCM),and to study the degree of left ventricular trabecular complexity in HCM and the relationship between excessive trabecular complexity and cardiac function.Materials and Methods From August 2020 to December 2022,a total of 80 patients with HCM from the Second Affiliated Hospital of Nanchang University were retrospectively analyzed.Additionally,80 healthy volunteers were recruited as the control group.Left ventricular functional parameters and fractal dimension(FD)of left ventricular trabecular myocardium were measured.The differences of mean global FD,max basal FD and max apical FD were compared between the HCM group and the control group,the correlation between FDs and cardiac function parameters was evaluated.The diagnostic efficiency of mean global FD,max apical FD and max basal FD was analyzed via receiver operating characteristic curve.Results The mean global FD of HCM group was significantly higher than that of normal group,and the difference was statistically significant(1.303±0.047 vs.1.229±0.026;t=-12.387,P<0.001).Mean global FD showed the best performance in differentiating HCM from normal control group.The optimal cut-off value for the diagnosis of HCM was 1.251,with the area under curve of 0.933(95%CI 0.896-0.969).Mean global FD was positively correlated with maximum wall thickness and left ventricular mass index(r=0.686,0.687,P<0.001),and max apical FD was positively correlated with left ventricular ejection fraction(r=0.520,P<0.001).Conclusion The FD obtained by cardiac magnetic resonance fractal analysis technique is reproducible and has definite value in the diagnosis of HCM,with association with the structure and function of left heart.

To scientifically evaluate the intervention effect of Chinese medicine preventive administration(combined use of Huo-xiang Zhengqi Oral Liquid and Jinhao Jiere Granules) on community population in the case of coronavirus disease 2019(COVID-19), a large cohort, prospective, randomized, and parallel-controlled clinical study was conducted. Total 22 065 subjects were included and randomly divided into 2 groups. The non-intervention group was given health guidance only, while the traditional Chinese medicine(TCM) intervention group was given two coordinated TCM in addition to health guidance. The medical instructions were as follows. Huoxiang Zhengqi Oral Liquid: oral before meals, 10 mL/time, 2 times/day, a course of 5 days. Jinhao Jiere Granules: dissolve in boiling water and take after meals, 8 g/time, 2 times/day, a course of 5 days, followed up for 14 days, respectively. The study found that with the intake of medication, the incidence rate of TCM intervention group was basically maintained at a low and continuous stable level(0.01%-0.02%), while the non-intervention group showed an overall trend of continuous growth(0.02%-0.18%) from 3 to 14 days. No suspected or confirmed COVID-19 case occurred in either group. There were 2 cases of colds in the TCM intervention group and 26 cases in the non-intervention group. The incidence of colds in the TCM intervention group was significantly lower(P<0.05) than that in the non-intervention group. In the population of 16-60 years old, the incidence rate of non-intervention and intervention groups were 0.01% and 0.25%, respectively. The difference of colds incidence between the two groups was statistically significant(P<0.05). In the population older than 60 years old, they were 0.04% and 0.21%, respectively. The incidence of colds in the non-intervention group was higher than that in the intervention group, but not reaching statistical difference. The protection rate of TCM for the whole population was 91.8%, especially for the population of age 16-60(95.0%). It was suggested that TCM intervention(combined use of Huoxiang Zhengqi Oral Liquid and Jinhao Jiere Granules) could effectively protect community residents against respiratory diseases, such as colds, which was worthy of promotion in the community. In addition, in terms of safety, the incidence of adverse events and adverse reactions in the TCM intervention group was relatively low, which was basically consistent with the drug instructions.
Adolescent ; Adult ; Betacoronavirus ; Coronavirus Infections ; drug therapy ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Pandemics ; Pneumonia, Viral ; drug therapy ; Prospective Studies ; Young Adult

Objective: To explore a predictive nomogram for the result of prostate biopsy based on Prostate Imaging Reporting and Data System version 2(PI-RADS v2)combined with prostate specific antigen (PSA) and its related parameters, and to assess its ability to diagnose prostate cancer by internal validation. Methods: We retrospectively analyzed the clinical data of 509 patients who underwent transrectal prostate biopsy guided by ultrasound during the period from January 2014 to December 2018 in the Department of Urology, First Affiliated Hospital of Xiamen University. In 509 cases, the mean age was (68.1±7.2) years. The mean prostate volume(PV) was (55.8±30.7) ml. The mean tPSA value was (19.86±18.94) ng/ml. The mean value of fPSA was (2.63±3.60) ng/ml and the mean f/tPSA was 0.14±0.08. The mean PSAD was (0.46±0.52) ng/ml2. Based on the PI-RADS v2, score 1 point have 37 cases, score 2 point have 131 cases, score 3 point have 152 cases, score 4 point have 102 cases, score 5 point have 87 cases. Of these patients, we randomly selected 80% (407 cases) as development group, and the other 20% (102 cases) as validation group. Univariate and multivariate logistic regression analysis of the development group was performed to identify the independent influence factors that can predict prostate cancer (PCa), thereby establishing a predictive model for the result of prostate biopsy. In the development group, validation group and tPSA was between 4.1-20.0 ng/ml, the model was evaluated by analyzing the receiver operating characteristic (ROC) curve, calibration curve and decision curve, and compared to PSA, fPSA, f/tPSA, PSAD, PI-RADS v2. Results: Among the 509 patients enrolled in the study, the detection rate of PCa was 43.0% (219/509). In the development group, the logistic regression analysis demonstrated that patient age (OR=1.113), f/tPSA (OR=0.004), PV (OR=0.986), PSAD (OR=11.023), digital rectal examination (DRE) texture (OR=2.295), transabdominal ultrasound (TAUS) with or without hypoechoic (OR=2.089), and PI-RADS v2 (OR=1.920) were independent factors for PCa (P<0.05). The nomogram based on all variables was established. In the development group, the area under the curve (AUC) of the model (0.883) was greater than those of tPSA (0.686), fPSA (0.593), f/tPSA (0.626), PSAD (0.777), PI-RADS v2 (0.761). In the validation group, the area under the curve of the model (0.839) was greater than those of tPSA (0.758), fPSA (0.666), f/tPSA (0.648), PSAD (0.832), PI-RADS v2 (0.803). In patients whose tPSA was between 4.1-20.0 ng/ml, the area under the curve of the model (0.801) was greater than those of tPSA (0.570), fPSA (0.426), f/tPSA (0.657), PSAD (0.707), PI-RADS v2 (0.701). The calibration curve of the nomogram indicated that the prediction curve was basically fitted to the standard curve, and the Hosmer-Lemeshow showed thatχ²=5.434, P=0.710, both suggested that the prediction model had better calibration ability. The decision curve showed that the model based on PI-RADS v2 had high clinical application value. Conclusions The nomogram based on PI-RADS v2 had a high predictive value for prostate cancer and could significantly improve the diagnostic performance. It had better diagnostic value than PSA and its related parameters. It also provided important guidance for the prostate cancer on clinical treatment of patients to some extent.

BACKGROUND: Whether the proximal tibial osteotomy in Mongolia populations has difference with other populations at home and abroad remains unclear.OBJECTIVE: To analyze the anatomical characters of the proximal tibial osteotomy in Mongolia populations in the northern region of China by measuring the relevant linear parameters.METHODS: Thirty-eight healthy Mongolia populations were selected, and their bilateral knee joints were scanned by CT.The original data were exported in DICOM format. Mimics software was used to reconstruct the knee three-dimensional model. The tibial data stored in STL format were imported into 3-matic software, showing the medial surface of the tibia,and 6 mm below the medial tibial plateau maintaining 7° posterior slop was subjected to total hip arthroplasty osteotomy.Subsequently, the relevant parameters were measured.RESULTS AND CONCLUSION: (1) The left tibia transverse diameter was (79.99±3.70) mm, and the right was (80.25±4.01) mm. The left anteroposterior diameter was (52.27±3.07) mm, and the right was (51.75±2.40) mm. The anteroposterior diameter of medial tibia was (55.40±2.00) mm (left), and (56.67±2.47) mm (right); the lateral was (49.84±2.78) mm (left), and (49.58±2.80) mm (right). (2) In Mongolian populations, the linear parameters showed no significant differences between two sides of the proximal tibial osteotomy (P > 0.05). The anteroposterior diameter of medial tibia was longer than that of lateral one (P > 0.05). The linear parameters of the proximal tibial osteotomy in male were significantly larger than those in female (P < 0.05). There were differences in the linear parameters of the proximal tibial osteotomy between Mongolian populations and other populations. (3)These results indicate that there are significant differences in the anatomical morphology of the tibial plateau between western and eastern countries.Besides, the geometric parameters of the tibial plateau may be different in different ethnic groups and regions. It is necessary to use the digital orthopedic technique to investigate and analyze the large sample data of different ethnic groups in different regions.

BACKGROUNDThe various risk factors for retinal hard exudates are still poorly understood in type 2 diabetic patients. The aim of this study was to determine the association between urinary albumin excretion rate (UAER) and hard exudates in macular region in north Chinese patients.

METHODSA total of 272 patients (272 eyes) were enrolled for this study, including 154 subjects from group 1 (mild hard exudates), 91 subjects from group 2 (moderate hard exudates) and 27 subjects from group 3 (severe hard exudates) confirmed using colour fundus photography, optical coherence tomography (OCT) as well as slit-lamp biomicroscopy with 78 diopter (D) lens. Each participant underwent a comprehensive assessment that included biochemical, clinical characteristics test and detailed ophthalmic evaluation. One-way analysis of variance (ANOVA) test and chi-square test were performed to analyze the fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG), full blood counts, urinary albumin excretion rate (UAER), blood creatinine (CREA), duration of diabetes, body mass index (BMI), systolic blood pressures (SBP) and diastolic blood pressures (DBP) between groups. Ordinal logistic regression analysis was further performed in order to eliminating the possible confounding factors.

RESULTSThree groups were matched in terms of age and gender. Risk factors which showed significant difference between groups include FBG (P < 0.001), HbA1c (P < 0.001), LDL (P < 0.001), UAER (P < 0.001), duration of diabetes (P = 0.001), TC (P = 0.005), SBP (P = 0.026), CREA (P = 0.004) and haemoglobin (Hb) (P = 0.012). There was no significant difference between groups for the TG, HDL, DBP, platelet, total white blood cells and BMI. Using ordinal Logistic regression analyses, of all the variables, HbA1c, LDL and UAER which were independent risk factor for hard exudates showed a significantly odds ratio of 1.25, 3.07, and 1.39, respectively. There were also significant differences in UAER level between patients with mild, moderate, severe hard exudates groups (P < 0.001).

CONCLUSIONSUAER was an independent risk factor associated with retinal hard exudates in macular region in type 2 diabetic patients. This study highlights the need for close monitoring and fundus examination for hard exudates in patients with elevated UAER to prevent irreversible visual loss.

Aged ; Albuminuria ; physiopathology ; Diabetes Mellitus, Type 2 ; physiopathology ; urine ; Female ; Humans ; Macular Edema ; physiopathology ; urine ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

Objective To evaluate the effectiveness and safety of terazosin in the treatment of benign prostatic hyperplasia (BPH)patients with concomitant hypertension.Methods A singlecenter prospective clinical observational study was conducted from March,2006 to March,2010 in our center.The main endpoints were the changes of IPSS total score,diastolic and systolic blood pressures at the end of 4 weeks and 3 monthes compared with the baseline,The second endpoints were Qmax value at the end of 4 weeks and 3 monthes compared with the baseline,Safety was assessed by adverse events.Results There were 212 patients in the study recruited,and 189 patients completed the study.All patients had BPH combined with hepertension.All patients were randomly devided into two statistical analysis group,blood pressure well controled and not well controled group,In the well controlled group,the IPSS socre reduced from 22.31 ± 5.18 at baseline to 15.64 ±3.91 at the end of the 4th weeks and 13.16 ± 3.53 at the end of 3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).The Qmax were improved significantly from (7.87 ± 2.41 ) ％ at baseline to (14.19 ±2.64)％ at the end of the 4th weeks and (15.69 ±2.77)％ at the end of3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).Terazosin had moderate effect in blood pressure decreasing (P ＜ 0.05 ),and all patients were within normal blood pressure range.In the uncontrolled group,the IPSS socre reduced from 21.55 ± 4.82 at baseline to 15.44 ± 3.66 at the end of the 4th weeks and 12.96 ± 3.11 at the end of 3rd monthes in the blood pressure well controled group populatin (P ＜ 0.01 ).The Qmax were improved significantly from ( 8.27 ± 2.27 ) ％ at baseline to ( 14.26 ± 2.87) ％ at the end of the 4th weeks and ( 15.51 ±2.92) ％ at the end of 3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).Terazosin decreased BPH patient blood pressure with controlled patients and unctrolled patients additionaly to other blood pressure medicine (P ＜ 0.05 ),and no severe side effect occured.At the end of the study,all patients were taking drug continuously and were followed.Conclnsion Terazosin can significantly improve the symptoms and quality of life in BPH patients with hypertension with good safety and compliance.

To determine the effect of pre-operative chemotherapy on apoptosis in breast cancer and to evaluate its signif icance as a prcgnostic marker. MethodsPatients with breast cancer were divided into preoperative chemotherapy group (40 cases)and control group (42 cases). Two groups were analyzed for the appearance of apoptosis by using TUNEL method and electron mi croscope in tissue sections. ResultsApoptosis occurred in 92.5 % of preoperative chemotherapy group and in 78.5 % of control group. The apoptotic indexes were 19.37 + 6.49 and 9.26 + 5.04 ( P ＜ 0.01 ) respectively. Low apoptotic index was related to disease-free survival of patients with breast cancer (P ＜ 0.01 ). ConclusionThe preoperative chemotherapy can induce apoptcsis of breast cancer and improve disease-free survival.

This study was designed to investigate the relationship between the hepatotoxicity of Halothane and altered hepatic calcium homeostasis in enzyme-induced hypoxic rats by means of Ca2+ cytochemistry location and EDX microanalysis combined with micropathological stereology of liver and ultrastructural analysis by computer. The results showed that more calcium precipitated the cytoplasm and mitochondria of liver following Halothane exposure than the controls. Based on the experiments, this alteration appeared to be contributed to the accelerated uptake of Ca2+ by the hepatocytes and lessened to pump out the decreased loaded Ca2+ on the other hand. The release of the reserved Ca2+ was increased by Halothane as compared with controls. These results suggest that a loss of regulation of cellular Ca2+ levels plays an important role in the mechanism of hepatotoxicity by Halothane exposure.